Healthy Living: Helping the doctors to increase survival rate

Richard Blackledge

When Julian Materna hurt his arm while cycling with wife Trudi in the Peak District, the pain he felt afterwards appeared nothing that the usual treatment for a common sporting injury couldn’t fix.

But later, when physiotherapy made little difference and the IT worker’s shoulder began to swell up massively, it slowly became apparent that his illness was something more untoward.

“We went to minor injuries initially, but they sent him home with paracetamol and said it should ease off in a few days,” said Trudi. “But then his shoulder swelled up, not quite football-sized, but pretty big.”

Julian, from Stannington in Sheffield, was referred to the Northern General Hospital, where a lesion was spotted on his left arm - a sign that he had in fact developed deadly osteosarcoma, a form of bone cancer which claimed his life aged 46.

“When we asked and they said it might be cancer, it was then that we found out,” said Trudi, 41.

“Once that happened, things began moving quickly - it just took time getting it picked up.”

Trudi is now backing a campaign by the Bone Cancer Awareness Trust, which is calling for earlier diagnosis by GPs after a report revealed survival rates for the disease have not improved in 25 years.

Symptoms often include painful bones or swollen joints, which can easily be put down to sporting injuries or, in younger patients, ‘growing pains’.

“Julian was pretty much the textbook version, apart from his age,” Trudi said.

“Primary bone cancer tends to affect teenagers and people in their early 20s, so for Julian, at 42 he wasn’t in the usual age range. I think that probably confused matters further.”

Osteosarcoma starts when a single bone cell becomes abnormal and grows out of control to form a tumour. The cells in the growth still act like bone, trying to create new bone as they grow and divide.

Julian was given chemotherapy at Weston Park Hospital, before undergoing surgery to amputate his left arm, shoulder blade and collarbone. But despite losing a limb, the outdoors enthusiast continued to indulge his passion for biking and climbing.

Julian was an access rep for the British Mountaineering Council with Trudi, who also served as secretary for the council’s Peak Area.

“Ultimately he was a better off-road rider than ever, and far braver and more skilful than me,” Trudi said. “He fell off a lot but he learned how to do that without injuring himself too much.”

In June 2011, after three years in remission, a routine check showed Julian’s cancer had returned in his right lung.

While writing a moving blog about his time as a cancer patient, Julian had further surgery and chemotherapy, and was starting to recover when yet more cancer was discovered. He died in June last year.

“He got breathless but wasn’t really poorly until the last two days,” Trudi said.

“I don’t think he would say that he was brave. He was just getting on with it, that was his mindset.

“There is a balance between being rational and alarming people. You don’t want to put the ‘C’ word into someone’s head unnecessarily, but if someone of Julian’s age has symptoms, maybe GPs should keep it at the forefront of their mind when making a diagnosis.”

Trudi has now moved to Cornwall, where she hopes to start working as a sports therapist, partly inspired by Julian’s experiences.

“When I was in Sheffield after he died, every time I drove down Manchester Road or up Barnsley Road near the Northern General, different things reminded me of bad times.

“Now I can think of happy memories, rather than sad ones.”

‘A simple X-ray makes a difference’

The Bone Cancer Awareness Trust is calling for GPs to be given more tools to make diagnoses earlier, after a report revealed survival rates have not improved in 25 years.

According to the National Cancer Intelligence Network, chances of surviving many common cancers have doubled, but bone cancer is lagging behind. The trust has teamed up with the Royal College of GPs to launch a specialist e-learning module, which could help doctors spot symptoms earlier.

Prof Andy Hall, chairman of the trust’s independent scientific advisory panel , said: “The average time it takes for a primary bone cancer patient to receive a correct diagnosis is 16 weeks. A simple X-ray, performed early, can make all the difference.”

The two most common primary bone cancers - where the rare disease actually originates in the bone - are osteosarcoma and Ewing’s sarcoma which often affect children, teenagers and young adults.